JP2005087548A - Ophthalmologic device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ophthalmologic device capable of examining eyes at an appropriate timing, obtaining eye examination data without failures and enabling even a patient who is not good at opening eyelids to be easily examined of his eyes. <P>SOLUTION: The ophthalmologic device is provided with a detection means for optically detecting the eye to be examined, a monitoring means for monitoring the eyelid open state or fixation state of the eye to be examined on the basis of the output of the detection means, a voice input means for inputting the voice of an examiner let out to the patient, a voice recognition means for recognizing the prescribed input information of the voice input means in the case that the monitoring means satisfies a prescribed judgement condition, and a control means for controlling eye examination on the basis of the voice recognition means. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an ophthalmologic apparatus for performing eye examination by aligning with an eye to be examined.

  Conventionally, voice input in the field of ophthalmology is a voice input of a troublesome operation of inputting a patient ID as described in Patent Document 1, and a voice input of a troublesome operation during surgery as described in Patent Document 2. Things are introduced. In addition, voice recognition technology has been improved, and IC recognition circuits have become widespread.

  On the other hand, as for an ophthalmologic apparatus, a fully automatic ophthalmologic apparatus that performs a process from alignment of an eye to be examined to automatic optometry and optometry of the opposite eye as disclosed in Patent Document 3 is also disclosed. Full-automatic operation has almost eliminated the operator's operation, and there is no difference in the skill of the examiner, and an accurate optometry can be performed with a uniform operation. In addition, it is convenient because the examiner can pay attention to the confirmation of the patient and can assist.

Japanese Patent Laid-Open No. 05-184544 JP 2001-108906 A JP 2000-33075 A

  However, full automatization is not problematic when the eye is fully opened, but in rare cases, when an eye with a disease in the anterior eye or an eye with poor opening is occasionally examined, Alignment must be performed manually, and the switch to start optometry must be performed manually. In that case, troublesome manual operation may be taken, and the eye cannot be quickly examined, resulting in discomfort to the subject.

  In addition, since the voice input means of the prior art introduced above has no condition on the timing of voice input and the switch for starting by input is turned on in advance, it does not want to input voice when the ON state is long. There is a possibility of recognizing even words. Moreover, in order to prevent misrecognition, it is troublesome to repeat ON / OFF of a switch, and operativity is bad.

  Therefore, in response to precautions when the examiner examines the eye, such as “Please open your eyes wide”, the device monitors the open state and can examine the eye at an appropriate timing. It is possible to obtain optometry data without failure, and even a subject who is not good at opening can easily perform optometry.

  Further, when the focus adjustment has to be performed manually as in the fundus camera, the focus adjustment can be performed while giving an instruction such as “please open your eyes wide”. In addition, when the examiner assists in raising the eyelid of the subject's eye, if the eye is recognized by voice recognition in response to an instruction such as “Yes, I will shoot”, the examiner will be half-body and one hand It is possible to concentrate on the assistance of the subject without taking an unnatural posture by pressing the photographing button of the operation unit on the opposite side of the subject with one hand. Further, by recognizing the voice pattern determined under the monitoring state, the voice recognition time is limited to a specific time, so that malfunction can be prevented without being interfered by the optometry of other devices.

  Accordingly, the object of the present invention is to provide an ophthalmologic apparatus that can perform optometry at an appropriate timing, obtain optometry data without failure, and allow a subject who is not good at eye opening to easily perform optometry. .

  In order to achieve the above object, the present invention comprises a detection means for optically detecting an eye to be examined, a monitoring means for monitoring an open state or a fixation state of the eye to be examined based on an output of the detection means, A voice input means for inputting the examiner's voice generated toward the person, a voice recognition means for recognizing predetermined input information of the voice input means when the monitoring means satisfies a predetermined judgment condition, and a voice recognition means. An ophthalmologic apparatus is configured including control means for performing optometry control based on the above.

  According to the present invention, the device monitors the open state in response to the precautions when the examiner examines the eye of the subject, for example, “Please open your eyes wide.” If optometry can be performed, optometry data without failure can be obtained, and a subject who is not good at opening can easily perform optometry.

  The present invention will be described in detail based on the illustrated embodiment.

  FIG. 1 is an external view of an ophthalmologic apparatus according to the present invention.

  On the surface operated by the examiner, a display device 1 (a liquid crystal monitor or a CRT monitor) for selecting display of measured values, an eye image, etc. and setting of various devices, a display unit for operating the display screen, A trackball 2 and a roller 3 for roughly aligning with the eye to be examined, a printer print switch 4 and a measurement start switch 5 are arranged.

  When operated by the examiner, the measuring unit 7 can move up and down, left and right, and forward and backward with respect to the main body fixing side 6, and the eye can be examined while being aligned with the subject eye. On the side opposite to the surface operated by the examiner, a chin rest on which the subject's face is placed is arranged, and the chin rest can be moved up and down by the chin rest vertical movement switch 8 on the side operated by the examiner. A microphone 9 for inputting voice is disposed on the measurement unit 7.

  FIG. 2 is an explanatory diagram of a measurement unit taking a tonometer as an example.

  A nozzle 12 is arranged on the central axis of the plane parallel glass 10 and the objective lens 11 so as to face the eye E, and an air chamber 13, an observation window 14, a dichroic mirror 15, a prism diaphragm 16, on the opposite side of the eye E, The imaging lens 17 and the image sensor 18 are arranged in this order. This is the light receiving optical path and the alignment detecting optical path of the observation optical system of the eye to be examined. The prism diaphragm 16 is provided with two openings symmetrically on both sides of the opening at the center of the optical axis, and the prisms are respectively arranged with their angles upside down so as to close the openings. A filter that cuts the wavelength of the measurement light source 27 is pasted behind the central opening, and a dichroic film that cuts the wavelength of the illumination light source described later is deposited on the prism.

  The air in the air chamber 13 is compressed by a piston 20 that is pushed up by the drive of a solenoid 19, and pulsed air is ejected to the eye E through the nozzle 12. In the reflection direction of the dichroic mirror 15, a relay lens 21, a half mirror 22, an aperture 23, and a light receiving element 24 are disposed, which is a deformation detection light receiving optical path. Here, the position of the aperture 23 is arranged at a position where a cornea reflection image of a measurement light source, which will be described later, is conjugated at the time of predetermined deformation.

  A half mirror 25, a projection lens 26, and a measurement light source 27 are arranged in the reflection direction of the half mirror 22, and a fixation LED 28 that can be fixed by the subject is arranged in the reflection direction of the half mirror 25. The measurement light source 27 uses a near-infrared LED that is used for both measurement and alignment with the eye to be measured in intraocular pressure measurement. The light beam of the measurement light source 27 projected onto the eye to be examined is converted into parallel light by the projection lens 25, and half It is bent by the mirror 25, imaged once in the nozzle 12 by the relay lens 21, and irradiated to the cornea of the eye E to be examined.

  The reflected light beam of the measurement light source 27 at the cornea passes through the parallel flat glass 10 and the objective lens 11 outside the nozzle 12. In the reflection direction of the dichroic mirror 15, a deformation detection light receiving optical system when the cornea of the eye E to be examined is deformed in the visual axis direction by the air emitted in a pulse shape is arranged. The cornea-reflected light beam transmitted through the half mirror 22 is designed to form a cornea-reflected image having substantially the same size as that of the aperture 23 when the relay lens 21 is deformed, and the received light beam is photoelectrically converted by the light-receiving element 24. It is converted into an electrical signal.

  The outer diameter of the plane parallel glass 10 is supported by the objective lens barrel 29, and illumination light sources 30a and 30b for illuminating the eye to be examined are arranged on the outside thereof. Further, a pressure sensor 31 for monitoring the pressure in the air chamber 13 when the piston 20 is moved by the solenoid 19 is disposed.

  The main body fixing side 6 is provided with a moving mechanism that can move the measuring unit 7 within a range of 90 mm in the left-right direction, 40 mm in the front-rear direction of the subject eye, and 30 mm in the up-down direction with respect to the eye to be examined. A motor to be driven is installed. The detailed configuration is equivalent to that described in Japanese Patent Application Laid-Open No. 8-126611.

  FIG. 3 is an electric block diagram of the entire system of the tonometer.

  To print a measurement board 5, a switch board 40 on which a printer printing switch 4 and the like are arranged, a trackball 2 for roughly aligning the measurement unit with the eye to be examined, a rotary encoder built in the roller 3, and a measurement result Printer 41 is connected to the MPU 42 port.

  The MPU 42 controls the entire system, a PROM 42a for storing a program for controlling the system, an arithmetic processing unit 42b for calculating data obtained from various devices (light receiving element, imaging element, etc.), and data input / output control I / O 42c and the like.

  The video signal of the anterior segment image of the eye to be examined photographed by the image sensor 18 is converted into digital data by the A / D converter 43 and stored in the image memory 44. The MPU 42 extracts a cornea reflection image of the eye to be examined based on the image stored in the image memory 44 and performs alignment detection. The video signal of the anterior segment image captured by the image sensor 18 is combined with the signal from the character generating device 45, and the anterior segment image, measurement values, and the like are displayed on the display device 1.

  The signal received by the light receiving element 18 and the pressure signal detected by the pressure sensor 31 in the air chamber 13 are amplified, converted into digital data by the A / D converter 46, and sequentially stored in the memory 47. When the MPU 42 detects the peak value of the light reception signal from the A / D converted PD element 24, the MPU 42 reads the data of the A / D converted pressure sensor 31 and stores it in the memory 47. All of the light reception signal and pressure signal data are stored in the memory 47.

  The audio signal input to the microphone 9 that is a part of the audio input unit 48 is amplified, AD converted, and input to the audio recognition unit 49. Here, the digital signal of the input voice is matched with the digital signal recognized by the voice pattern, and it is determined whether or not it matches the voice registered in advance. The determined result is called by the MPU 42 at a necessary timing and used for the next control.

  The up / down motor 50, the front / rear motor 51, the left / right motor 52, and the chin rest driving motor 53 are connected to motor drivers 54, 55, 56, and 57, respectively, and are driven by commands from the MPU 42. The solenoid 19 is connected via a drive circuit 58 and is driven and controlled based on a command from the MPU 42. The measurement light source 27 and the illumination light sources 30a and 30b that illuminate the eye to be inspected are connected to the D / A converter 59, and can change the amount of light according to a command from the MPU 42.

  In such a configuration, alignment with the eye to be examined is performed as follows.

  That is, the face of the subject is placed on the chin and the measurement start switch 5 is pressed. The magnification of the observation optical system is low, and only the eye to be examined can observe the eye E regardless of the size of the face. Therefore, the video signal of the image sensor 18 is periodically captured at a predetermined timing of about 0.5 seconds with the input of the optometry start switch 5.

  When the eye E is imaged on the image sensor 18 as shown in FIG. 4A, the video signal is A / D converted by the A / D converter 43 and stored in the image memory 44. If not detected, it is overwritten and erased. When the pixels in the pupil region of the eye E are darker than the other portions (the level of the video signal is low) and binarized at a predetermined level, the pupil region is extracted as shown in FIG.

  Next, the MPU 42 calculates the centroid of this pupil region, and calculates the amount of deviation between the position and the appropriate position. Further, a driving amount corresponding to the calculated shift amount is calculated, and the upper and lower motors 50 and 52 are driven via the motor drivers 54 and 56. When the measurement unit 7 is almost aligned with the proper position, the video signal of the image sensor 18 is captured again. The captured image is displayed as shown in FIG. 4C, and this time, the corneal reflection image Rc of the light beam of the measurement light source 27 irradiated from the inside of the nozzle 12 is separated by the prism diaphragm 16 and imaged in the pupil. Has been.

  Similar to pupil extraction, when binarization is performed at a predetermined level, a bright spot image Rc ′ in the pupil can be extracted as shown in FIG. This bright spot image is as shown in FIG. 4 (e) in the case of an appropriate position, and is shifted as shown in FIGS. With respect to the direction shift, the two bright spot images Rc ′ are shifted in the vertical and horizontal directions. More detailed alignment is performed from the positional relationship between the two bright spot images. A slight amount of deviation is also instructed by instructing each motor to drive according to the amount of displacement, and the measuring unit 7 is moved for alignment.

  When alignment is performed in this manner, optometry (in this case, intraocular pressure measurement) is automatically performed.

  However, it is not only the eye to be examined with such a good eye opening. As shown in FIG. 5, there is rarely an eye to be examined that does not open well. When the examiner looks at the monitor and the eye open state is bad, say “please open your eyes wide”, the examinee's eyes are primarily shown in FIGS. 4 (c), (e), (f). However, there are cases where the process returns to FIG. 5 again. In order to perform the measurement in such a short time, the following technique is incorporated in the present invention.

  FIG. 6 is a flowchart showing a series of optometry operations.

  When the subject's face is placed on the chin and the measurement start switch 5 is pressed, the video signal of the image sensor 18 is periodically output at a predetermined interval (about 0.5 seconds) as described above in step S1. It comes to capture. The video signal captured by the image sensor 18 is detected by the method described above in step S2, and the presence or absence of the pupil is determined in step S3.

  If the area below the predetermined level is not as large as the pupil, it is determined that there is no pupil, and the process returns to step S1. At this time, the measurement unit 7 can be forcibly moved by operating the trackball 2 or the roller 3 while the images are captured at a predetermined interval. If it is determined that there is a pupil, the operation of the trackball 2 and the roller 3 is not accepted, and the voice input standby state is started in step S4.

  In step S5, the open state of the eye to be examined is detected. As a detection method, pupil detection is performed and the upper area of the pupil cannot be detected in a predetermined area (the upper part of the pupil is missing, or more than half is missing), or the pupil boundary area is extracted from the contrast difference. However, there is also a method of judging based on the size of the portion where the boundary area is out of the circular shape.

  In addition, the open state can not only determine whether or not it is blocked by a ridge but also quantitatively determine the degree of blocking. Step S6 is a step of determining the open state. If OK, the process proceeds to step S7. If it is NG, it is checked in step S8 whether there is a voice input. Here, when the examiner utters words such as “please open your eyes wide” and “please open your eyes”, the voice input from the microphone 9 is recognized as a voice pattern determined in advance by the voice recognition unit 49. Matching is performed in step S9. In this case, since the word is a voice pattern in advance, it is determined in step S10 that the word is related to opening, and the process returns to step S5.

  If there is no voice input in step S8, the process returns to step S5 via determination step S11. On the other hand, if it is determined in step 10 that the word is not related to opening, the process proceeds to step S7. In the determination step 11, after returning to step S 5, if the process proceeds from the determination step S 6 and the determination step S 8 again, that is, if the open state is bad and there is no voice input, it is determined whether or not a predetermined time has elapsed. It has become.

  If it is determined that the predetermined time has elapsed, the process proceeds to determination step S12, and if not, the process returns to step S5. In the determination step 12, it is checked whether the opening state has been improved compared to the previous time in the detection of the opening state in step S5, and if it is determined that a certain degree of opening has been made, although not complete, a step will be described later. Migrate to

  In step S7, an operation of moving the measurement unit 7 from the positional deviation amount of pupil detection is performed. In the determination step S13, pupil detection is performed again, and it is determined whether or not the center of the pupil is within a predetermined allowable range. If the allowable range is entered, the process proceeds to step S14. If the allowable range is not entered, the process returns to step S1, and the steps from the detection of the pupil to the movement of the measurement unit 7 are repeated (S2 to S7).

  In step S14, the bright spot detection described above is performed. Two bright spots projected in the pupil are extracted to detect a positional shift as to whether or not the detailed alignment between the eye to be examined and the measuring unit 7 has been completed. In determination step S15, it is determined whether or not the positional deviation detected in step S14 is an appropriate position. If it is not the proper position, the process returns to step S7 according to the amount of deviation, and the measurement unit 7 is moved. If it is in an appropriate position, in this case, an intraocular pressure measurement is performed in step S16.

  In intraocular pressure measurement, first, the drive of the solenoid 19 is started, the piston 20 moves, and air is ejected from the nozzle 12. The eye cornea to be examined is deformed by the air, a predetermined deformation state is detected by the light receiving element 24, and the pressure in the air chamber at that time is detected by the pressure sensor 31 and converted into an intraocular pressure value.

  In step S17, the voice input standby start in step S4 is terminated, and voice input from the microphone 9 is not accepted. In determination step S18, it is determined whether a measurement result has been obtained. If the eyelids were opened, but there was a blink or fixation disparity at the moment of measurement, a measurement error may occur. If a measurement result cannot be obtained, the process proceeds to determination step S19, where it is determined whether or not to remeasure.

  For example, if the setting condition of the apparatus is set to measure three times for each eye and the measurement error is set to be measured again up to two times, the process returns from determination step 19 to step 1 until the condition is satisfied. If the re-measurement condition is satisfied, the process proceeds to decision step 20 to determine whether or not to measure the opposite eye. If one eye has already been measured, the measurement ends. If it has not been measured yet, the process moves to step 21 to perform control for driving the measuring unit 7 to the opposite eye. Since the distance between the pupils of the eye to be examined is normally 62 mm, the movement to the opposite eye position is performed by a predetermined amount.

  If it is determined in the determination step 12 that the open state has been improved to some extent, the process proceeds to step S16 to forcibly start the measurement. It is important for the examiner to obtain accurate measurement values, but in the case of intraocular pressure measurement, secondary examinations such as contact-type precision intraocular pressure measurement and fundus examination may be performed. It is also desirable to produce some measure of reference. When a measurement result is obtained in the determination step S17 by this measurement, it is easy to understand if a measurement numerical value is displayed as a low-reliability data in which the open state is insufficient by adding a “*” mark or the like next to the data.

  As described above, when the eyelid of the eye to be inspected is raised and the position is immediately adjusted by the opening instruction to the subject by voice input, measurement without failure can be performed. Also, when the examinee does not place the face correctly on the chin, or when the forehead is not firmly placed on the forehead, when the examiner assists with both hands, or when the eye is opened by voice input It can be measured quickly and is convenient.

  The embodiment described above is an example in which measurement is smoothly performed by voice input when the eye open state is not good, but the next embodiment is when the eye fixation state is poor, The words that call attention are input by voice, and the optometry operation is performed smoothly.

  Next, a fundus camera and a reflex keratometer will be described as examples.

  FIG. 7 shows a plan view of the internal configuration of the measuring unit 7 'of the reflex keratometer.

  On the central axis O of the measuring unit 6 that is aligned with the visual axis of the eye E, a kerato ring light source 60, a dichroic mirror 61 that totally reflects visible light and partially reflects a light beam having a wavelength of 880 nm, an objective lens 62, and a hole. A mirror 63, an aperture 64, a projection lens 65, a projection aperture 66, and a measurement light source 67 of 880 nm are arranged. In the reflection direction of the perforated mirror 63, a six-divided aperture 68, a six-divided prism 69, a light receiving lens 70, and a two-dimensional image sensor 71 are arranged.

  The above-described optical system is an optical system for measuring eye refraction, and the luminous flux emitted from the measurement light source 67 is focused by the projection diaphragm 66, and is primarily imaged by the projection lens 65 in front of the objective lens 62, and the objective. The light passes through the lens 62 and the dichroic mirror 61 and is projected to the center of the pupil of the eye E to be examined. The luminous flux forms an image on the fundus, and the reflected light enters the objective lens 62 again through the periphery of the pupil. The incident light beam becomes thick and is totally reflected by the perforated mirror 63. The reflected light beam is divided into six by a six-divided aperture 68, refracted by a six-divided prism 69 so as to be received within an appropriate range of the light-receiving surface area of the two-dimensional image sensor 71, and a six-point spot image is projected. It has become.

  If the eye E is normal, the approximate curve connecting the centroids of the six spot images becomes a predetermined circle, and the curvature of the approximate curve circle increases or decreases in the myopic and hyperopic eyes. When there is astigmatism, the approximate curve is an ellipse, and the angle formed by the horizontal axis and the major axis of the ellipse is the astigmatic axis angle. The refraction value is obtained from the coefficient of the approximate curve of the ellipse.

  On the other hand, in the reflection direction of the dichroic mirror 61, a fixation target projection optical system and an alignment light receiving optical system that shares an anterior ocular segment observation, kerato measurement, and alignment detection are arranged. In the alignment light receiving optical system, a lens 72, a dichroic mirror 73, an alignment prism diaphragm 74, an imaging lens 75, a kerato diaphragm 76, and a two-dimensional image sensor 77 are arranged. The light source for alignment detection is also used as a measurement light source 77 for measuring eye refraction, and the light beam projected from the measurement unit 6 is reflected by the cornea C of the eye E to be examined. The reflected light beam returns to the measuring unit 6 again, is reflected by the dichroic mirror 61, becomes a parallel light beam by the lens 72, is reflected by the dichroic mirror 73, and is guided to the light receiving optical system.

  In the alignment light receiving optical system, the alignment prism diaphragm 74 and the kerato diaphragm 76 can be inserted and removed on the optical path. Only the alignment prism diaphragm 74 is inserted into the optical path during refraction measurement, and only the kerato diaphragm 76 is inserted during kerato measurement. It has become so. The alignment prism diaphragm 74 is provided with three openings horizontally as in the above-described intraocular pressure measurement prism diaphragm 16, and a dichroic film that transmits a light beam only in the vicinity of a wavelength of 880 nm is deposited on the two prisms on both sides. Has been.

  The light beam that has passed through the alignment prism stop 74 is refracted in the vertical direction, and the light beam having a wavelength of 780 nm or more of the anterior segment illumination 78a, 78b passes through the central opening. Therefore, the reflected light beam of the anterior segment image illuminated by the anterior segment illumination 78 a and 78 b passes through the central aperture of the alignment prism diaphragm 74 and is imaged on the two-dimensional image sensor 77 by the imaging lens 75. The thus-configured reflex keratometer alignment detection optical system can perform from pupil detection to detailed alignment bright spot detection in the same manner as the above-described intraocular pressure measurement.

  Next, the fixation projection optical system will be described.

  A fixation projection optical system is disposed on the transmission side of the dichroic mirror 73. A total reflection mirror 79, a fixation guide lens 80, a fixation chart 81, and a fixation projection light source 82 are arranged. During fixation fixation, the projection light flux of the fixation projection light source 82 that is lit up the fixation chart 81. Illuminated from the back side and projected onto the fundus of the eye E through the fixation guide lens 80 and the lens 72. The fixation guidance lens 82 can move in the optical axis direction so as to cope with a change in the diopter of the eye E.

  FIG. 8 is a part of an electric block diagram of the reflex keratometer.

  It is similar to the intraocular pressure measurement block diagram, and the same reference numerals are devices having equivalent functions. In addition, the measuring switch 5, the switch board 40, the trackball 2, the roller 3, the printer 41, and the motor and driver for moving the measuring unit 7 'and the motor for driving the chin rest and the driver are also connected. Here, the illustration is omitted.

  A video signal of the anterior segment image of the eye to be examined captured by the two-dimensional image sensor 77 is converted into digital data by the A / D converter 43 and stored in the image memory 44. The MPU 42 extracts a cornea reflection image of the eye to be examined based on the image stored in the image memory 44 and performs alignment detection. In the kerato measurement, after the kerato diaphragm 76 is inserted, the captured kerato ring image is stored in the image memory 44, and the ring image is extracted and elliptically approximated to measure the corneal curvature radius.

  An image captured by the two-dimensional image sensor 71 is also converted into digital data by the A / D converter 90, stored in the image memory 91, and a 6-point spot image is extracted to measure the eye refractive power. In the case of the reflex measurement, the fixation target is presented to the subject's eye, the fixation guide lens 82 is moved by the fixation lens driving motor 92, and the fixation target is presented so that the subject is presented with the index at the far point. Make it cloudy. In the reflex measurement, a correct measurement value cannot be obtained unless measurement is performed so that the near point is not seen by adjusting the refraction of the subject's eye. There is a period of several seconds for the eye to fixate the fixation target, and correct measurement cannot be performed even if the fixation position shifts during that time.

  Therefore, it is better to monitor the fixation state and warn if the fixation state remains shifted. In this embodiment, when there is a fixation disparity in the cloud fog, the fixation is stabilized by a word that the examiner calls attention, and in that case, measurement can be performed immediately. The positional relationship between the pupil and the two bright spots is monitored by a two-dimensional imaging element 77 every predetermined time (for example, every field), and it is determined whether the positional relationship has changed greatly to determine whether the fixation is shifted. It is like that.

  FIG. 9 is a flowchart for measuring when the eyelid state and the fixation state are confirmed in the cloud fog and the state of the eye to be examined is improved by voice input. It is a part of the whole optometry operation, and is a flow from cloud operation to measurement. The same symbols indicate the same functions.

  Position alignment between the eye to be inspected and the measurement unit 7 ′ was performed in the same manner as the above-described intraocular pressure measurement, and it was confirmed in step S <b> 50 that auto-alignment was completed, that is, adjusted to an appropriate position. In step S51, a cloud fog change to change the fixation target presentation state is performed by the fixation guide lens 80. This is mainly the movement of the fixation guide lens 80.

  In step S52, after the cloud fog is started, the voice input unit 48 is set in a voice input standby state. In step S5, the open state is detected in the same manner as the above-described intraocular pressure measurement. In step S6, the open state is determined. If OK, the fixation state is detected in step S53. If it is NG, if there is a voice input such as “please open your eyes” at decision step S8, voice recognition is performed at step S9.

  Voice recognition is performed by matching whether or not input voice information is recognized as a predetermined voice pattern. When it is recognized in the determination step S10 that the word is related to the open state in the matching, the process returns to step S5, and the open state is detected again. If it is not a word concerning the open state, if it is a word concerning the fixation state in step S54, for example, “please look straight”, “please see the red house in the middle”, etc., to the fixation state detection in step S53 Move.

  The fixation state detection is performed by monitoring the positional relationship between the pupil of the eye to be examined and the bright spot at predetermined time intervals as described above. In step S55, the fixation state is determined. If the result is OK, the clouding operation is continued in step S56 to the completion state. If it is NG, the process proceeds from step S8 → S9 → S10 → S54, and it is determined whether there is a voice input and whether the voice recognition is in the open state or the fixation state. If there is no voice input (NO in step S8) and the speech-recognized word is not a cautionary word in an open state or a fixation state (NO in step S54), the process proceeds to decision step S11. In the determination step S11, when the open state or the fixation state is poor and there is no voice input, it is determined whether or not a predetermined time has elapsed.

  If it is determined in S12 that the open state has been improved after a predetermined time, it is determined in determination step S57 whether the fixation state has been improved. If improvement of the fixation state is recognized, the process proceeds to REF image capture in step S58. Here, although it is in the middle of cloud fog, the eye open state and fixation state of the subject's eye did not become complete opening and fixation state despite the examiner's attention, but there was some improvement. Since it is expected, an image for reflex measurement can be captured in this state.

  If the open state and the fixation state are not improved in the determination step S12 and the determination step S57, the process proceeds to step S59, where the apparatus emits a warning sound or displays a warning on the display device and ends the measurement. When the reflex image is captured, the voice input standby state is terminated in step S17, and the transition voice input is not accepted.

  As described above, not only the open eye condition but also the fixation state is monitored, and the entire optometry operation can be performed smoothly by measuring immediately after improving the open eye and poor eye fixation with voice input. Can do. As an ophthalmologic apparatus for monitoring the fixation state, it can be similarly applied to a subjective refractometer and a visual acuity meter.

  Next, an apparatus for monitoring the fixation state in the fundus camera and photographing when the fixation is improved by voice input will be described.

  FIG. 10 shows a configuration diagram of an optical system of a fundus camera.

  On the optical path of the objective lens 100 facing the eye E, an external eye observation lens 101, a perforated mirror 102 having an opening in the center, a focus lens 103, a photographing lens 104, and a rotatable mirror 105 are arranged. In the fixation optical system above the mirror 105, a liquid crystal display 106 and a light source 107 for fixing the eye E to be examined are arranged.

  A field lens 108, a field stop 109, an imaging lens 110, and an image pickup unit 111 are arranged on the optical path behind the mirror 105. A lens 112 and a ring stop are provided on the optical path in the incident direction of the perforated mirror 102. 113 and the light source 114 are arranged, and the ring diaphragm 113 is disposed substantially conjugate with the perforated mirror 102 with respect to the lens 112.

  Further, the output of the imaging means 111 is connected to the control means 115, the output of the control means 115 is connected to the television monitor 116, and the outputs of the photographing switch 117, the fixation target moving switch 118, and the external eye observation lens switch 119 are respectively It is connected to the control means 115.

  In such a configuration, the light beam emitted from the fundus observation light source 114 passes through the opening of the ring diaphragm 113 and the lens 112, is reflected to the left by the mirror part of the perforated mirror 102, and passes through the objective lens 100. The fundus Er of the optometry E is illuminated. The reflected light beam from the fundus Er passes through the pupil Ep, the objective lens 100, the aperture of the apertured mirror 102, the focus lens 103, the photographing lens 104, and the field lens 108, and once forms a fundus image near the field stop 109. Then, the image is formed again on the imaging means 111 by the imaging lens 110.

  The fundus oculi image Pr formed on the image forming unit 112 is converted into a video signal and is displayed on the television monitor 116 via the control unit 115. A voice recognition unit 49 is also built in the control means 115. Further, the AD conversion unit of the voice input unit is also built in the control unit 115, and the microphone 9 is also connected to the control unit 115.

  The examiner turns on the external eye observation lens switch 119 so as to insert the external eye lens 101 into the optical path in order to perform the anterior eye observation. Position alignment is performed by observing the anterior segment, and the external lens 101 is removed from the optical path when it is aligned to an appropriate position. In order to observe the fundus moving image displayed on the TV monitor 115, adjust the focus lens 102 to aim the fundus image Pr, and further photograph a desired part of the eye E, the fixation target moving switch 117 is set. By operating, the fixation target position of the liquid crystal display 105 is moved. After the examiner guides the eye E to a desired site, the examiner presses the imaging switch 116 to emit the fundus imaging light source 113 and records the fundus image Pr as a still image in the storage unit inside the control unit 114.

  FIG. 11 is a flowchart for monitoring the open state and the fixation state of the fundus camera and photographing when the state of the eye to be examined is improved by voice input. The same symbols indicate the same functions.

  Here, the alignment between the eye to be examined and the fundus imaging unit is not automatic alignment, but the movable plate on which the imaging unit is mounted is moved in the up / down / left / right and front / rear directions by a joystick. When the alignment is completed, the external eye observation lens 101 is switched (step S60). When the external eye observation lens 101 is switched, the process automatically proceeds to step S61, and a standby state for voice input is started.

  In step S62, the open state is detected. Here, the open state at the time of fundus observation is determined, but the video signal imaged by the imaging unit 111 is taken into the image memory inside the control unit 115 as in the above-described tonometer and reflex keratometer. When the captured image is poorly opened and wrinkled, as shown in FIG.

  In step S62, this white and strong reflected light beam region is detected. In determination step S63, the ratio of the white reflected light beam area to the entire imaging unit area is determined to determine the open state. In the determination step S63, the open state is determined. If OK, the fixation state is detected in S64. If the eye to be examined is in a poorly opened state, the process proceeds to determination step S8, and if there is a voice input such as “please open your eyes wide”, voice recognition is performed in step S9. Voice recognition is performed by matching whether or not input voice information is recognized as a predetermined voice pattern.

  When it is recognized in the determination step S10 that the word is related to the open state in the matching, the process returns to step S62, and the open state is detected again. If the word is not related to the open state, the process proceeds to step S54. When a word related to the fixation state is recognized in step S54, for example, “please look straight” or “please look at the red house in the middle”, the process proceeds to fixation state detection in step S64. Since the fixation state detection is fundus observation, the determination is based on the position of the nipple, not the pupil detection.

  FIG. 13 is an image obtained by extracting the nipple Nc. The examiner operates the fixation target moving switch 119 to confirm the position of the nipple Nc immediately after the operation and the position of the nipple Nc when the fixation target is moved to a desired position after the operation, and the fixation position of the eye to be examined. Is detected (moves in the direction of the arrow etc. in FIG. 13), and it is confirmed that the position of the nipple Nc is not shifted after a predetermined time when the fixation is stable, and the fixation is detected. To do.

  If the fixation state is determined in the determination step S65 and the result is OK, fundus photographing is permitted in step S66, and fundus photographing is performed by the input of the photographing switch 115. If it is NG, the process proceeds from step S8 → S9 → S10 → S54, and it is determined whether there is a voice input and whether the voice recognition is in the open state or the fixation state. If there is no voice input (NO in step S8) and the speech-recognized word is not a cautionary word in an open state or a fixation state (NO in step S54), the process proceeds to decision step S66.

  The determination step S66 is a determination step of whether or not the examiner has recognized a word such as “Yes, I will shoot” when the examiner permits photographing by judging from the state of the subject and the observation state of the fundus. This is effective when the examiner is busy with the assistance of the eye to be examined or when the examiner is busy with focus adjustment described later. When this voice recognition for photographing permission is determined, the process proceeds to step S67. If there is no photographing permission sound, the process proceeds to judgment step S11.

  In the determination step S11, it is determined whether or not a predetermined time has elapsed when the open state or the fixation state is poor and there is no voice input. If it is determined in S12 that the open state has been improved after a predetermined time, it is determined in determination step S57 whether the fixation state has been improved. If improvement in the fixation state is recognized, fundus photographing is permitted in step S67, and fundus photographing is performed at the input of the photographing switch 115.

  Although the focus adjustment is omitted here, the operator can operate immediately before and after operating the fixation target moving switch 117 so that the image can be taken immediately when the open state and the fixation state become favorable. In addition, the focus adjustment can be performed while the examiner indicates the opening or fixation attention in words, and the optometry movement can be performed smoothly. If the open state and the fixation state are not improved in the determination step S12 and the determination step S57, the process proceeds to step S59, where the apparatus emits a warning sound or displays a warning on the display device and ends the photographing. When the fundus image is captured, the voice input standby state is terminated in step S17, and the transition voice input is not accepted.

  As described above, even with a fundus camera, the eye open state and fixation state of the eye to be examined are monitored, the state of eye opening and fixation by voice input is improved, and fundus photography can be performed immediately thereafter, so the optometry operation is smooth There is no shooting failure. Even when the examiner's hand must open the screen, it is effective when adjusting the focus manually.

  The present invention is applicable to an ophthalmologic apparatus that performs eye examination by aligning with an eye to be examined.

It is an external view of an ophthalmologic apparatus. It is an optical layout of a non-contact tonometer. It is an electrical block diagram of the whole system of a tonometer. It is explanatory drawing of a to-be-examined eye detection. It is a to-be-examined eye figure with a bad open state. It is an optometry flowchart which made the tonometer an example. It is an optical arrangement drawing of a reflex keratometer. It is a system block diagram of a part of a reflex keratometer. It is a flowchart of a part of reflex keratometer. It is the optical arrangement | positioning figure and block diagram of a fundus camera. It is a flowchart of a part of fundus camera. It is a fundus view with a bad open state. It is explanatory drawing of a nipple image extraction.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Display apparatus 6 Main body fixed side 7 Measuring part 9 Microphone 12 Nozzle 18 Image pick-up element 24 Light receiving element 27 Measuring light source 31 Pressure sensor 42 MPU
48 voice input unit 49 voice recognition unit 71, 77 two-dimensional imaging device 81, 106 fixation target 115 means for controlling fundus camera

Claims (8)

  Detection means for optically detecting the eye to be inspected, monitoring means for monitoring the open state or fixation state of the eye to be inspected based on the output of the detection means, and voice of the examiner generated toward the subject Voice input means for inputting; voice recognition means for recognizing predetermined input information of the voice input means when the monitoring means satisfies a predetermined judgment condition; and control means for performing optometry control based on the voice recognition means. Ophthalmic device characterized by   The ophthalmologic apparatus according to claim 1, wherein the control means is alignment control for optometry.   The ophthalmologic apparatus according to claim 1, wherein the control means is control for starting tonometry.   The ophthalmologic apparatus according to claim 1, wherein the control unit is a control for starting the acquisition of a fundus image for eye refractive power measurement.   The ophthalmologic apparatus according to claim 1, wherein the control means is control for starting the acquisition of a fundus image for fundus photography.   2. The ophthalmologic apparatus according to claim 1, wherein the monitoring unit is a monitoring unit that extracts a pupil of an eye to be examined and monitors an open state.   2. The ophthalmologic apparatus according to claim 1, wherein the monitoring unit is a monitoring unit that extracts a pupil and a corneal reflection image of an eye to be examined and monitors a fixation state based on a positional relationship between the extracted images.   The ophthalmologic apparatus according to claim 1, wherein the monitoring unit is a monitoring unit that extracts a nipple of an eye to be examined and monitors a fixation state.

Images